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General NPI Number Information
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NPI Number | 1730061490
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC CENTERS OF AMERICA LLP
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 809 S SHORE DR
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-4219
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Country | US
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Telephone | 952-905-5602
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Fax |
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Provider Business Mailing Address
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Address Line | 5775 WAYZATA BLVD STE 400
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1271
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Country | US
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Telephone | 866-674-7933
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Fax |
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Authorized Official
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Title or Position | SPECIAL ASSISTANT SECRETARY
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Name | RAMONA L AHERN
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Credential |
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Telephone | 952-738-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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